Provider Demographics
NPI:1578742235
Name:DEAN, JEFFREY L (MSED)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:L
Last Name:DEAN
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 STATE ROUTE 417 W
Mailing Address - Street 2:
Mailing Address - City:WELLSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14895-9332
Mailing Address - Country:US
Mailing Address - Phone:585-593-6300
Mailing Address - Fax:585-593-7071
Practice Address - Street 1:4220 STATE ROUTE 417 W
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14895-9332
Practice Address - Country:US
Practice Address - Phone:585-593-6300
Practice Address - Fax:585-593-7071
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health